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FORWARDWASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. (T) -CMI -41m- <br /> GENERATOR -- -__ .;- REQUIRED PERSONAL PROTECTWE EQUIPMENT y <br /> WILLIAM S T Ew A_R_T _ _ ❑GLOVES [:]-GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> !I-ING ADDRESS ❑TY VEK [:]OTHER <br />' <br /> 452 w _L 0 W E L _"AVE AVE. <br /> - w SPECIAL HANDLING PROCEDURES <br /> CITY,STATE ZIP_rs`- <_� ;�= _M =_-,a �t. �� <br /> • TRACY , CA 95367 _ r <br />' PHONE=-moi- - -a._.wn. <br /> 209-855-5148 <br /> CONTACST PERSON <br /> WILLIAM STEWART <br /> SIGNATURE OF AUTHORIZED AGENT`!TITLE a° DATE <br />' WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br />' • ❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> ;1_ ,a . 11Ti ST <br /> TRA C A (209) 982- 1009 FAX <br /> NAME NOTES TRUCK NUMBER <br /> RICH 4,4 IlLT`] i T,1UC<1 1GS <br /> DDRESS <br /> . CITY, STATE ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> - - —7 ' —� , - El ❑ ❑ <br /> SIGNS-IRE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> 'f - ❑ ❑ ❑ ❑ <br /> ell <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste of weather or other <br /> conditions Rmpair the sate and effective d=osal of the waste or if the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill Forward shall use <br /> reasonable efforts to promptfy notify Disposer of its inability to accept the DISPOSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on 0 <br /> IL <br /> weather or other site conditions Forward shall notify the Disposer when saa--' <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ SLUDGE <br /> REMARKS <br /> NON-FRIABLE <br /> ❑ <br /> FACILI1( TICKET NUMBER ASBESTOS <br /> ❑ WOOD <br /> SIGNATYKE OF AUTHD;IZED AGENT/ j DATE <br /> f s ❑ ASH <br /> � -t� �� !C� _L� ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR'TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> I TO SCHEDULE CALL (209) 982-4298 MANIFEST # C 5450 <br /> GENERATOR COPY <br />